standing emotions and managing emotions. The four subscales of theWLEIS are self-perception of emotions, other-perceptions of emotions,understanding emotions, and regulation of emotions. Results: Of the247 students approached, 152 agreed to participate (response rate 62%).The mean age was 24 (standard deviation [sd]�3), 61 (40%) were male,and 75 (49%) were White. The MSCEIT provides scores on a normativescale, where the normative mean is 100 and the normative sd is 15 onall subcales and on the overall scale. Thus, we expected to find medicalstudent means greater than 100. Instead, medical student means weresimilar to the general population on all 4 subscales and overall (means98.31 - 100.54), although medical students were less variable than thegeneral population (sds ranged from 7.9 to 12.9). The WLEIS does nothave extensive norms. However, medical student scores tended to behigher than available comparison groups (overall mean 5.06 vs 4.63),and again, variance of medical student scores was lower. Although boththe MSCEIT and the WLEIS purport to measure emotional intelli-gence, the correlations between the MSCEIT and WLEIS were lowerthan expected in the subscales (range 0.00 - 0.24), and the correlationbetween overall scores was 0.18. The MSCEIT was developed as anability test (e.g., what is the person in this picture feeling?), but theWLEIS was developed as a direct self-report measure (e.g., how goodare you at controlling your emotions?). Because of this difference in itemtypes, it is perhaps not too surprising that the scores on the two testsshow a small correlation. Conclusion: By two measurements, medicalstudents appear similar to the general population in terms of emotionalintelligence. This finding was particularly strong for the MSCEIT,which does not depend on a direct self-evaluation of emotional intelli-gence. Research is needed to understand the impact of emotional intel-ligence on performance in the third and fourth year of medical school,and also on how to better elucidate emotional intelligence of medicalstudents.

QS51. ULTRASOUND TRAINING OF SURGICAL ATTEND-INGS AND RESIDENTS: A PILOT STUDY OF LEARN-ING ASSESSMENT. Kathryn M. Tchorz1, Kresimira M.Milas2, Randall S. Friese3, Margaret M. Dunn1, Jonathan M.Saxe1, A. Marilyn Leitch3; 1Wright State University Boon-shoft School of Medicine, Dayton, OH; 2The Cleveland ClinicLerner College of Medicine, Cleveland, OH; 3University ofTexas Southwestern Medical School, Dallas, TX

Introduction: Surgeon-performed ultrasound has become stan-dard practice in many surgical subspecialties, but efforts to testlearning goals and objectives in ultrasound training are not welldescribed. Therefore, a pilot study was conducted to study theeducational value of goal-directed test question design. Methods:Twenty-one study participants, comprised of trauma/critical careattendings and senior surgical residents, were enrollled in anintensive 1-day ultrasound course which was comprised of didac-tic and hands-on sessions. All participants had real-life experienceutilizing ultrasound in the trauma setting and gave verbal con-sent for study participation. Inclusion criterion was successfulcompletion of the American College of Surgeons (ACS) Ultrasoundfor Surgeons CD-ROM module. A 20-question, pre-course test wasadministered, each with 5 multiple choice answers covering spe-cific course learning goals and objectives. Didactic sessions in-cluded: 1) Essential Ultrasound Physics Principles 2) TraumaUltrasound 3) Ultrasound in the SICU 4) Ultrasound for the AcuteAbdomen 5) Breast Ultrasound 6) Thyroid/Parathyroid Ultra-sound and 7) Focused Vascular Ultrasound. Hands-on sessionsincluded: 1) Interventional 2) Hepatobiliary/Vascular 3) FAST/Cardiac/Thoracic 4) Breast and 5) Neck/Thyroid/Parathyroid. Apost-course test was administered, consisting of the same 20 pre-test questions but in a re-arranged order. A passing grade was80% correct answers. There was no review of the pre-test ques-tions at any time during the course. All ultrasound instructorswere nationally recognized in ultrasound proficiency by the ACS

and/or surgical subspecialty associations. Results: Of the 21 studyparticipants, there were 10% (2/21) PGY 3s, 24% (5/21) PGY 4s, 33%(7/21) PGY 5s and 33% (7/21) attendings. Pre-course raw scores were15.3 � 2.2 and post-course scores were 17.7 � 1.1. Pre-course andpost-course pass rates were 57% and 100% respectively. Mann-WhitneyU Test p�0.57 (NS). Conclusions: Both faculty and surgical residentsidentified gaps in their ultrasound knowledge and applied the newlyacquired information to obtain a 100% pass rate on the post-course test.Emphasis on goal-directed question design may lead to increasedknowledge obtained from intensive educational sessions. However, amore sophisticated study design, coupled with the testing of long-termknowledge retention, will be required to properly study the impact ofthis type of educational endeavor.

QS52. EFFICACY OF THREE TOPICAL HEMOSTATICAGENTS APPLIED BY MEDICS IN A LETHAL GROININJURY MODEL. Vance Y. Sohn, Zachary Arthurs, MatthewEckert, Jason Perry, Matthew Martin, Alec C. Beekley, Rob-ert M. Rush, Jr.; Madigan Army Medical Center, Tacoma, WA

Background: Advanced topical hemostatic agents are increasinglyutilized to control traumatic hemorrhage. We sought to determinethe efficacy of three chitosan based hemostatic agents in a lethalgroin injury model when applied by combat medic first responders.Methods: After creation of a standardized femoral artery injury in agoat model, medics attempted hemorrhage control with standardgauze dressing followed by randomization to one of three hemostaticagents in this two tiered study. In the first tier, medics were ran-domized to either a chitosan based one-sided wafer (OS) or a dual-sided, flexible, roll (DS). In the second tier, medics were randomizedto the flexible DS dressing or a chitosan powder (CP). Efficacy ofgauze, each chitosan agent, proper application, and participant sur-veys were obtained and included for analysis using univariatetechniques. Results: From January 2007 to June 2007, 55 (45%) DS,36 (29%) OS, and 32 (26%) CP agents were used to treat 123 activelybleeding arterial injuries in 64 animals. Standard gauze failed tostop hemorrhage in 122 (99%) groins. Hemostasis at 2 and 4 minutesare provided in graphic format (p > 0.05). Although all threechitosan agents were marginally effective at 2 minutes, the recom-mended time for application, hemostasis improved after 4 minutes.The DS dressing was the most effective, controlling hemorrhage 76%at 4 minutes. Of the failures, 3 (25%) DS and 9 (53%) OS were due toimproper application. End-user survey results demonstrated thatmedics preferred the DS dressing 77% and 60% over the OS and CP,respectively. Conclusions: Chitosan based bandages are significantlymore effective at hemorrhage control compared to standard gauze fielddressings. The dual-sided chitosan dressing demonstrated better hem-orrhage control than the one-sided dressing and the chitosan powderand was less likely to fail despite application errors.

QS53. PASSING A VIRTUAL REALITY-BASED CURRICU-LUM AND SKILLS EXAM IMPROVES LAPARO-

290 ASSOCIATION FOR ACADEMIC SURGERY AND SOCIETY OF UNIVERSITY SURGEONS—ABSTRACTS

SCOPIC SKILLS IN NOVICES. Michael Martinez1, KurtE. Roberts1, Robert L. Bell1, James Dziura1, Lucian Panait2,Andrew J. Duffy1; 1Yale University School of Medicine, NewHaven, CT; 2St. Mary’s Hospital, Waterbury, CT

Introduction: Ethical concerns for patient safety, training hoursrestrictions, and operating room costs are challenging the doc-trines of surgical training. Training outside the operating room(OR) has become an essential component of surgical education.Computerized simulators are increasingly being used for laparo-scopic and endoscopic training but factory settings and metricshave been incompletely developed and evaluated. The LapSim(Surgical Science, Göteborg, Sweden) is a laparoscopic virtualreality simulator that allows an instructor to customize curriculato the skill level of the trainee. We developed a basic laparoscopicskills curriculum for our trainees, establishing specialized diffi-culty settings and metrics. Similarly, a skills exam was designedto be completed at the end of the curriculum. We hypothesize thatnovice trainees who complete our novel, virtual reality-basedlaparoscopic skills curriculum and pass the exam will demon-strate improved technical performance as measured by Funda-mentals of Laparoscopic Surgery (FLS) drills. Methods: Thirty-two 1st and 2nd year medical students with no prior laparoscopicsurgical or simulator experience volunteered and were prospec-tively randomized to various training schedules. All subjects werefamiliarized with basic laparoscopic skills and instruments. Base-line skills evaluations were performed using two FLS tasks (pegtransfer and pattern cutting). During training periods, the groupstrained regularly with the goal of completing the curriculum andpassing the exam. Trainees had repeat skills testing using thesame FLS tasks at one month intervals, through 3 or 4 months oftraining (depending on group assignment). All trainees had equalopportunity to complete the curriculum and exam during thestudy period, regardless of initial group assignment. FLS perfor-mance scores were calculated for each task. Scores were comparedboth within and across groups for differences in improvementthroughout training interventions. Scores were compared betweensubjects who passed the entire curriculum and exam (“passers”)and all other subjects (“non-passers”). Changes in test scores foreach task were compared using two-sample t-Tests assuming un-equal variances. Results: Ten of thirty-two subjects (31%) com-pleted the entire curriculum and passed the exam. Twenty-twosubjects were in the non-passers’ group. There were no significantdifferences in baseline scores between the groups for either task.There were no significant differences between the groups on thepeg transfer skill. The group that passed the curriculum and examdemonstrated significantly higher scores for the pattern cuttingtask (195 versus 142, p � 0.001). The mean improvement of taskscores for pattern cutting over the initial baseline scores wassignificantly higher for passers versus non-passers (134 versus 88,p� 0.05). Conclusions: Successful completion of our basic lapa-roscopic skills curriculum and exam results in improved noviceskill development as determined by FLS scores. Surgical residentswho complete our practice curriculum and pass the exam shoulddemonstrate improved OR performance.

QS54. USE OF A COMPUTERIZED SURGICAL SIMULATORTO EVALUATE GROSS AND FINE MOTOR DEXTER-ITY. Aaron Goldberg, Stephanie R. Goldberg, James P. Ne-ifeld; VCUHS, Richmond, VA

Introduction: Surgically oriented residency programs face anever increasing burden of providing both adequate training andevaluation of resident surgical skills in an environment of strictduty hour limitations, declining surgical volume and increasedemphasis on patient safety. The growth of laparoscopic surgeryhas fostered the emergence of computerized surgical simulators

and their use in surgical training programs. While such simula-tors may provide a valid simulation of laparoscopic surgery, theirutility in assessing fine and gross motor dexterity remains uncer-tain. The goal of this study was to compare performance betweena computerized simulator and validated tests of fine and grossmotor dexterity, which is inherent in all forms of surgery. Meth-ods: Following IRB approval, fourth year medical students (whohad no previous exposure to laparoscopic simulators or formalsurgical training) underwent testing using the Stromberg dexter-ity test of gross motor function, the O’Conner Tweezer test of finemotor function, and performed a series of standardized tasksusing the MIST VR computerized surgical simulator (MenticeCorporation, Gothenburg, Sweden). All scores were recordedbased on the number of seconds to task completion. In addition, allparticipants were asked to list the number of activities requiringmanual dexterity in which they participate (i.e., cooking, playingmusical instruments, playing video games, etc.), with a maximumof five. Performance on each of these tests was compared to eachother and to the number of activities requiring dexterity usingSpearman’s correlation coefficient, with significance defined asp�0.05. Results: Data were collected on 113 medical studentparticipants. Medial performance times on the Stromberg dexter-ity test, O’Conner Tweezer test, and MIST VR computerizedtrainer were 149.0 seconds, 349.0 seconds, and 46.7 seconds, re-spectively. Performance on the computerized simulator was sig-nificantly correlated with both gross motor performance as mea-sured by the Stromberg dexterity test (p�0.02) and withparticipation in a greater number of activities requiring manualdexterity (p�0.01). Conclusion: Performance on initial experi-ence with computerized surgical simulators such as the MIST VRsystem correlate well with gross motor dexterity as well as self-reported participation in activities requiring manual dexterity.These results suggest that computerized surgical simulators mayprovide a proxy for both the development and evaluation of grossmotor surgical skill in medical students and surgical residents.

QS55. A NOVEL PUBLIC HEALTH PROGRAM TO TEACHTEENAGERS ABOUT SKIN CANCER. Caroline Arthur1,Adrian Alexander2, Joel Crockett2, Taylor Greenwood2,Stephanie Lickerman3, Frank E. Johnson2; 1Washington Uni-versity, St. Louis, MO; 2Saint Louis University, St. Louis,MO; 3Melanoma Hope Network, St. Louis, MO

Introduction: Skin cancer presents a major public health chal-lenge for the surgical community. While largely a preventabledisease, skin cancer affects more Americans than all other cancerscombined and was the leading cause of cancer death in women25-30 years of age in 2005. The primary modifiable cause of skincancer is exposure to ultraviolet radiation. Education directed atminimizing sun exposure would likely reduce the incidence of thedisease. As treatment is primarily surgical, surgeons have anopportunity to educate patients about sun protection. We devel-oped an educational program, the Sun Protection Outreach Teach-ing by Students (SPOTS) program, for teenagers, a key group totarget as it is estimated that the majority of lifetime sun exposureoccurs before age 18. The program is a collaborative effort amongsurgeons, dermatologists, and medical students to affect theknowledge and behavior of teenagers regarding skin cancerawareness and prevention. Methods: SPOTS was developed byfaculty and students from Washington University and Saint LouisUniversity and the Melanoma Hope Network, a non-profit orga-nization. SPOTS is in its second year as part of the electivecurriculum at both medical schools. It consists of interactive ses-sions conducted by medical and allied health students in second-ary schools. Sessions include a PowerPoint lecture, games, a videoof teens with melanoma, a skin analyzer machine, handouts, anddemonstrations of sun protective Methods and tanning alterna-tives. IRB-approved questionnaires were administered three

291ASSOCIATION FOR ACADEMIC SURGERY AND SOCIETY OF UNIVERSITY SURGEONS—ABSTRACTS